Improving teamwork: impact of structured interdisciplinary rounds on a hospitalist unit

J Hosp Med. 2011 Feb;6(2):88-93. doi: 10.1002/jhm.714.

Abstract

Background: Effective collaboration and teamwork is essential in providing safe and effective care. Research reveals deficiencies in teamwork on medical units involving hospitalists.

Objective: The aim of this study was to assess the impact of an intervention, Structured Inter-Disciplinary Rounds (SIDR), on nurses' ratings of collaboration and teamwork.

Methods: The study was a controlled trial involving an intervention and control hospitalist unit. The intervention, SIDR, combined a structured format for communication with a forum for regular interdisciplinary meetings. We asked nurses to rate the quality of communication and collaboration with hospitalists using a 5-point ordinal scale. We also assessed teamwork and safety climate using a validated instrument. Multivariable regression analyses were used to assess the impact on length of stay (LOS) and cost using both a concurrent and historic control.

Results: A total of 49 of 58 (84%) nurses completed surveys. A larger percentage of nurses rated the quality of communication and collaboration with hospitalists as high or very high on the intervention unit compared to the control unit (80% vs. 54%; P = 0.05). Nurses also rated the teamwork and safety climate significantly higher on the intervention unit (P = 0.008 and P = 0.03 for teamwork and safety climate, respectively). Multivariable analyses demonstrated no difference in the adjusted LOS and an inconsistent effect on cost.

Conclusions: SIDR had a positive effect on nurses' ratings of collaboration and teamwork on a hospitalist unit, yet no impact on LOS and cost. Further study is required to assess the impact of SIDR on patient safety measures.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Communication
  • Cooperative Behavior
  • Diagnosis-Related Groups
  • Efficiency*
  • Efficiency, Organizational / standards*
  • Efficiency, Organizational / statistics & numerical data
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Nursing Service, Hospital / statistics & numerical data
  • Patient Care Team / organization & administration
  • Patient Care Team / standards*
  • Patient Care Team / statistics & numerical data
  • Quality of Health Care / standards*
  • Quality of Health Care / statistics & numerical data
  • Safety / standards*
  • Safety / statistics & numerical data
  • United States